John D. Chovan, James R. Cacchillo
Bronchial Casts, Treatment
Medical Pathology | Nursing | Respiratory Tract Diseases
Plastic bronchitis is a condition characterized by the formation of bronchial casts ranging from small to large obstructions of the pulmonary airways. Cast formation is intricate and resembles a plastic, rubbery model of the airway it obstructs. Its form was first described by Galen (A.D. 131-200). One of the patient populations at risk for developing this rare complication are those with single ventricle disease who are surgically corrected to Fontan physiology. It is a very abnormal type of circulation that is suspect in the development of plastic bronchitis. The cellular composition of plastic bronchitis differs from the casts seen in patients with chronic respiratory diseases such as asthma or lymphatic disorders of the lung and, as a result, complete airway obstruction may occur more quickly with a resultant life- threatening and possibly fatal event. Bronchial casts may also be seen in other disease states such as sickle cell disease, metastatic lung tumors, bronchopulmonary aspergillosis, thalassemia alpha, and inhalation injuries (Do, Randhawa, Chin, Parsapour, & Nussbaum, 2012). Tissue plasminogen activator in an aerosolized form has shown to be effective therapy in most cases. The following information is an update on the adaptation of this therapy in the last 5 years.
Ferroni, Ruth, "Review of the Effectiveness of Tissue Plasminogen Activator for the Treatment of Plastic Bronchitis in Patients with Fontan Physiology" (2014). Master of Science in Nursing (MSN) Student Scholarship. Paper 55.